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    FM-MSU-IIT-RGTR-002 Application For Leave of Absence

    Uploaded by

    Aya Sismondo
    The document provides an application form for students at Mindanao State University - Iligan Institute of Technology to apply for a leave of absence. The form requests information such as the student's name, ID number, courses, GPA, period for the leave, and reason for requesting the leave of absence. It must be signed by the student, adviser, department chair, dean, and registrar.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    FM-MSU-IIT-RGTR-002 Application For Leave of Absence

    Uploaded by

    Aya Sismondo
    22 views2 pages
    The document provides an application form for students at Mindanao State University - Iligan Institute of Technology to apply for a leave of absence. The form requests information such as the student's name, ID number, courses, GPA, period for the leave, and reason for requesting the leave of absence. It must be signed by the student, adviser, department chair, dean, and registrar.

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    FM-MSU-IIT-RGTR-002 Application for Leave of Absence

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    The document provides an application form for students at Mindanao State University - Iligan Institute of Technology to apply for a leave of absence. The form requests information such as the student's name, ID number, courses, GPA, period for the leave, and reason for requesting the leave of absence. It must be signed by the student, adviser, department chair, dean, and registrar.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    22 views2 pages

    FM-MSU-IIT-RGTR-002 Application For Leave of Absence

    Uploaded by

    Aya Sismondo
    The document provides an application form for students at Mindanao State University - Iligan Institute of Technology to apply for a leave of absence. The form requests information such as the student's name, ID number, courses, GPA, period for the leave, and reason for requesting the leave of absence. It must be signed by the student, adviser, department chair, dean, and registrar.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    MINDANAO STATE UNIVERSITY Document Code No.

    ILIGAN INSTITUTE OF TECHNOLOGY FM-MSU-IIT-RGTR-002


    Revision No. Effective Date Page No.
    OFFICE OF THE REGISTRAR 00 02.20.2020 1 of 2

    APPLICATION FOR LEAVE OF ABSENCE

    1. Name: ___________________________________________________________________________
    Last Name First Name M. I.
    2. Student ID No.: ________________ College/School: _____________ Course: _________________
    3. Mailing Address: ____________________________________________________________________
    ___________________________________________________________________
    5. E-mail address: _________________________________ Contact No.______________________
    4. Semester and Academic Year Last Attended: _____________________________________________
    5. Total Number of Units Taken: ________________ Total Failure (units): ___________
    6. Cumulative GPA: ___________________
    7. Period Covered by Leave of Absence: _____________________________________________
    8. Reason(s) for Leave of Absence:
    _________________________________________________________________________________
    _________________________________________________________________________________
    _________________________________________________________________________________

    ________________________________ _______________________
    Student’s Signature over Printed Name Date

    Approved Disapproved

    Adviser: ____________________________ Date: ___________


    Signature over Printed Name

    Chairperson: _________________________ Date: ___________


    Signature over Printed Name

    Dean: ______________________________ Date: ___________


    Signature over Printed Name

    Parental/Marital Consent: Approved:

    ________________________ ________________ __________


    Signature over Printed Name Institute Registrar

    Accomplish in 3 copies – for the Registrar, the Department and the Student.
    If currently registered, file also a withdrawal form (Form 8: Academic Load Revision Permit) provided that it is done within the withdrawal
    period.

    A. Bonifacio Avenue, Tibanga, 9200 Iligan City Telephone Nos: (063)221-4050 to 55 Local 4165, Tele/fax(063) 223-
    Website: http://www.msuiit.edu.ph 3794, e-mail:registrar@g.msuiit.edu.ph
    MINDANAO STATE UNIVERSITY Document Code No.
    ILIGAN INSTITUTE OF TECHNOLOGY FM-MSU-IIT-RGTR-002
    Revision No. Effective Date Page No.
    OFFICE OF THE REGISTRAR 00 02.20.2020 2 of 2

    A. Bonifacio Avenue, Tibanga, 9200 Iligan City Telephone Nos: (063)221-4050 to 55 Local 4165, Tele/fax(063) 223-
    Website: http://www.msuiit.edu.ph 3794, e-mail:registrar@g.msuiit.edu.ph

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